Short gut syndrome (SGS) results from the massive intestinal resection that is often necessary in a broad array of medical and surgical treatments. Following a massive small bowel resection (SBR), a compensatory process occurs in the remnant bowel termed adaptation. This response is largely a mitogenic signal culminating in taller villi, deeper crypts, and an expanded mucosal absorptive and digestive surface area. The significance of adaptation is underscored by the requirement in SGS patients of nutrition by vein for the duration of the patient's lifetime if this response is inadequate. It has been demonstrated that exogenous EGF enhances several morphologic parameters of adaptation and its use has been proposed as a treatment for SGS. A unique collaboration between researchers at the Donald Danforth Plant Science Center and physician scientists at the St. Louis Children's Hospital and Washington University School of Medicine will develop and do animal testing of a soy-milk formula produced from soybeans genetically engineered to synthesize EGF. This novel transgenic EGF soy-based formula may provide a low-cost, minimal-risk therapy for SBR patients as a means to reduce SGS. Plant-based production would have many advantages in terms of production costs, world-wide distribution, and stability. This approach may provide a simple means of reducing SGS, and the associated high-cost most often borne by public resources. PUBLIC HEALTH RELEVANCE: Short gut syndrome occurs after a massive small bowel resection (SBR) that is often necessary in a broad array of medical and surgical treatments. After a massive SBR a compensatory process occurs in the remnant bowel termed adaptation which has been shown to be enhanced by Epidermal Growth Factor (EGF). A milk formula produced from soybeans genetically engineered to synthesize EGF will be developed as this may provide a simple, more cost- effective means of enhancing intestinal adaptation in patients suffering from massive intestinal loss.